Provider Demographics
NPI:1528162641
Name:ALVAREZ BATLLE, MARINA (DDS)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ALVAREZ BATLLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6063 VINELAND AVE #A
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4917
Mailing Address - Country:US
Mailing Address - Phone:818-760-8201
Mailing Address - Fax:818-255-2802
Practice Address - Street 1:6063 VINELAND AVE #A
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4917
Practice Address - Country:US
Practice Address - Phone:818-760-8201
Practice Address - Fax:818-255-2802
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9319101OtherDENTICAL MEDICAL